The swift excommunication of a nun for approving an abortion has triggered a debate over church doctrine–and raised questions about whether Catholic hospitals routinely break federal law.

Earlier this year, Sister Margaret McBride was excommunicated from the Catholic Church for approving an abortion needed to save a woman’s life. An administrator at St. Joseph’s Hospital in Phoenix, McBride was part of the hospital’s ethics committee that decided in November 2009 to allow a 27-year-old woman with pulmonary hypertension, or high blood pressure in the arteries that supply blood to the lungs, to terminate her 11-week pregnancy. Due to her condition, the woman would almost certainly have died without the abortion.

After learning of McBride’s decision, Diocese of Phoenix bishop Thomas J. Olmsted declared in May that she was “automatically excommunicated” and asked her to resign her post as vice-president of mission integration at St. Joseph’s. Olmsted, who is responsible for three of the ten church excommunications ordered this century, said in a statement, “An unborn child is not a disease. While medical professionals should certainly try to save a pregnant mother’s life, the means by which they do it can never be by directly killing her unborn child. The end does not justify the means.”

McBride’s excommunication has raised questions about the quality of reproductive care women receive at Catholic healthcare facilities. The American Civil Liberties Union (ACLU) cited the case in a July 1 letter requesting an investigation by the federal Centers for Medicaid & Medicare Services (CMS) into whether religiously affiliated hospitals provide adequate emergency reproductive care. “Sister McBride’s subsequent treatment and the diocese’s unambiguous statement sends the message to other hospital employees, at St. Joseph’s and at other Catholic hospitals around the country, that they risk punishment if they provide life-saving pregnancy terminations in the future,” ACLU attorneys wrote.

The ACLU listed three cases documented in a 2008 American Journal of Public Health article in which women were denied emergency reproductive care at Catholic hospitals. It called on the CMS to enforce the Emergency Medical Treatment and Active Labor Act, which requires hospitals that participate in Medicare and Medicaid to treat patients in emergencies and active labor. The ACLU also asked the agency to formally clarify that denying emergency reproductive care violates federal law: “There is no basis for a hospital to impose its own religious criteria on a patient to deny her emergency medical care.” The agency’s only response was a form letter sent in late July, according to the ACLU.

Catholic hospitals, which operate 15 percent of the nation’s hospital beds, are required to follow the Ethical and Religious Directives for Catholic Health Care Services. The directives state: “Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted.”

However, St. Joseph’s Hospital–and presumably McBride, who declined an interview request and is now vice-president of organizational outreach at the hospital–saw some gray areas in these instructions. “In those instances where the directives do not explicitly address a clinical situation–such as when a pregnancy threatens a woman’s life–an Ethics Committee is convened to help our caregivers and their patients make the most life-affirming decision,” the hospital said in a May statement. “In this tragic case, the treatment necessary to save the mother’s life required the termination of an 11-week pregnancy.”

McBride’s excommunication has stirred debate among Catholics about when abortion is permissible. Catholic doctrine does allow “indirect abortions,” in which the treatment of a serious health condition results in the death of a fetus, and some theologians thought this case might qualify. The U.S. bishops’ Committee on Doctrine, however, released a statement in June making it clear that it considers the Phoenix abortion direct.

Olmsted’s decision to declare McBride excommunicated has also been a subject of controversy. Abortion is one of seven crimes in the church code of canon law that result in latae sententiae, or automatic excommunication at the moment the act is performed. However, in light of the difficulty of the choice McBride faced–whether to protect the fetus until the mother’s near-certain death or act preemptively–some think Olmsted should have spared her the church’s harshest penalty.

In a National Catholic Reporter column this year, priest and canon lawyer Thomas P. Doyle wrote, “The canonical criminality of the choice made by the sister and the others is by no means … cut and dried … [T]he full recitation of the facts … seem to argue for the protection of the sister, the mother and all others involved from the harshness of excommunication rather than for their condemnation.”

Robin Peterson is a former managing editor of the Chicago Weekly, an alternative weekly of Chicago's South Side. Originally from Troy, Ohio, she attended the University of Chicago and is a former editorial intern at In These Times.

Wow, you've got me pegged to a Tea (party)--misogynist, hates religion, hates women, it's a crime to provide healthcare...eeek, I've been exposed by Ayn Rand Key! (T-he, he, he, he.....)
Wait, wait, wait, there's more. Let me just clear the milk that came out of my nose while I was drinking it reading your post....
"Wow, I guess I did touch a nerve." Um, if I had any left to touch, you'd be the first one I'd call since you think you can "touch" them through the In-ter-net.
"Since they cannot stay open AND provide abortions AND not provide abortions, they close their door."
You already established that the Catholic hospitals do in fact provide abortions "under their noses." Okay, wait a minute, they do provide abortions? They don't? Didn't a nun just get excommunicated for authorizing an abortion of a pregnant person with a condition that threatened the said pregnant person should they carry the pregnancy to term?
And are those doors still "open" where that nun was excommunicated?Posted by LD on 2010-10-19 21:17:36

Wow, I guess I did touch a nerve.
So now you are discussing the church going against federal law in favor of Church law, saying that the church will somehow "trump US law". But the closing of the hospital doors is the way they have to obey *both* laws. Since they cannot stay open AND provide abortions AND not provide abortions, they close their door. There is no law that states they must stay open. Closing their doors is hardly trumping US law.
In order to buttress the remaining shreds of your argument you, an alleged progressive, indulge in misogyny while disguising it as an attack on the Catholic Church, and the Catholic Church must be attacked for the crime of providing health care.
So now we've established that you hate women and hate religion. What's next?Posted by Ayn R. Key on 2010-10-19 20:19:55

Insinuations--Ayn,
You didn't learn that word in Catholic School because it would have been an affront for you as a woman to have learned it, let alone use it in a sentence. You realize that the Church doesn't approve of such avant-garde language by the female, and will have to take actions against you for such an infraction against church doctrine (a la misogyny.)
Let's see. If I were to apply your threat that the ACLU should "think carefully" about demanding the Church follow US law, whilst they simply close their doors, and let people die in the process by doing so (sans 15% hospital bed inventory,) then it follows that you might get, I don't know, whacked for going against Church doctrine (edict: using language not afforded to women to speak or write.)
I guess you would know. How many women are killed in the Church in any given year, in any given country for going against any such Church doctrines? I suspect statistics exist internally on that, since that would be a terrific scare tactic to keep women "in-line," like the mafioso do to the people who move against their wishes in their "organizations."
Brilliant scheme these behemoth religions with rigid mandates that somehow trump US law, lest they threaten to kill people instead!Posted by LD on 2010-10-19 15:39:44

LD is angry. He has run out of arguments, and is now blithering. It's quite a spectacle.
All because I didn't respect his bad experience in an emergency room as superior to actually speaking to people at the management level, and wouldn't let him get away with unsupported insinuations.Posted by Ayn R. Key on 2010-10-19 15:00:46

Did you know that E=MC(squared?) It's true, forever and ever and ever... Kansas is not here, Dorothy.
So, when Ayn R. Key says despotism means "X," it therefore means "X" as defined by said garbally-goop logic noted above. Got it Einstein! I'll remember that Ayn R. Key is actually the Wizard of Oz when I need to get the exact definition of a theoretical construct, like Relativity for instance, when I need it, since you have proven your "if-then-else" stream-of-consciousness capabilities to the blogosphere above as unquestionably and notoriously perfect!Posted by LD on 2010-10-19 10:33:24

Oh boy, LD, now since I've actually talked to management I'm willing to make sacrificial lambs out of ... well, you never did go far enough to say who, nor did you say who the chosen ones were. Insinuation is enough, because you can't refute insinuations, you can only refute direct statements.
When you have no direct statements to support your case, insinuations are all that is left. Mind, I'm not saying you have no direct statements...
So now we're at the stage where a service provider who doesn't provide a service is a raw savage despot. Fascinating, really. Real despots can actually compel people to act under threat of punishment.
What, exactly, is the hospital compelling people to do? Well, you could say they are imposing their morality on others by withholding services ... but that doesn't fit the criteria of a despot. You could say they are forcing people to act in a certain way by threatening to close their hospital ... but that doesn't fit the criteria again. Withholding something valued is not the same as applying a punishment.
It's the carrot and the stick - you can provide or withhold the carrot, and you can apply or withhold the stick. The hospital is withholding carrots. The despot applies the stick. Most people are grown up enough to know the difference. I'm not saying that you aren't...Posted by Ayn R. Key on 2010-10-19 09:54:58

"...since this woman was (obviously) diagnosed and being treated..."
There was no overt statement of treatment present at the time of the crisis, and no mention of ongoing treatment measures already in place for this person.
Your argument completely rests on this premise, and as such, falls apart completely (especially since you put the word "obviously" in parentheses.)Posted by LD on 2010-10-19 09:17:03

Ayn Rd Key--
"As someone who does know people at the management level, and talked with them about issues such as mandatory coverages, I got an entirely different perspective on management issues than someone in the emergency room. I guess your experience does trump mine. Not."
I liken your "superiority complex" to your religious beliefs--a totalitarian mandate that designates some as "chosen ones," and all other peoples as that which one discards or uses as "sacrificial lambs."
All your posts are evidentiary of your beliefs in this regard, and notably detail a much broader epidemic of raw savagery of despotism as doctrine within the Catholic Church, ergo the Catholic Hospital system.Posted by LD on 2010-10-19 09:13:46

LD, I see where you are coming from. You had a bad experience at a Catholic Hospital, and therefore you know what is said at the upper levels of management. That makes perfect sense, doesn't it?
As someone who does know people at the management level, and talked with them about issues such as mandatory coverages, I got an entirely different perspective on management issues than someone in the emergency room.
We discussed matters of secular law, church law, and application of each. That doesn't often happen in the emergency room.
I guess your experience does trump mine.
Not.Posted by Ayn R. Key on 2010-10-19 08:28:49

LD,
Re-read what I said - there was once a 50% mortality rate for UNTREATED PPH during pregnancy - since this woman was (obviously) diagnosed and being treated her mortality chance was probably 5% AT THE WORST.Posted by Rick Stump on 2010-10-19 07:34:03

Ayn Rd
Having been treated in a Catholic Hospital emergency room, I have first-hand knowledge of the "idealistic stand" you speak of, and the "money grubbing" character that you say I speak of. From my own experience as a patient, both characters, the idealist and the money grubber, work within the Catholic Hospital, throughout the system.
First, there's the ER staff/doctors/nurses who won't respond to your pain or your concerns, let's just say in a "respectful manner" as a patient because you aren't Catholic, aren't married, and might be....eeeeek.....gay--the idealistic standards you speak of.
Second, there's the hospital A/R accounting staff that repeatedly deny your insurance coverage, then repeatedly harass you for not paying the bill immediately, all the while sending you bills that put charges on in triplicate, essentially racking up three times the cost of the original charge--the money grubbing standards of which you speak about.
Yes, you are right Ayn. Both the idealist and the money grubber exist in the charitable, not-for-profit Catholic Hospital system. Good job pointing that out, Ayn R(and) Key!!!Posted by LD on 2010-10-16 17:34:47

Nice of LD to say I was describing "Obamacare", and nice of LD to say I made it up, and nice of LD to say assume I had no idea the Catholic Church's position on abortion prior to the passage of the recent fiasco of health care reform. LD is wrong on all three points.
The only legitimate point you've made is that it is possible for it to go on under their noses, as long as the leadership is unaware of what is going on. As the article demonstrated, if the leadership is aware, then the church does indeed take action.
It is a principle of the Catholic Church that they will not do it. I know you think they are lousy immoral money-grubbing unidealistic hypocrites just like everyone else who has ever disagreed with you on any point what-so-ever, but some of these immoral money-grubbing unidealistic hypocrites are actually moral self-sacrificing idealistists who take firm stands that disagree with you. It is possible for someone to idealistically disagree with you.
And that brings us right back to a church that would sooner close a hospital than perform an abortion. It is an idealist stand, which means that they would never ever do that because people don't take idealistic stands that disagree with you. They'd actually take a loss, which means they wouldn't do it because people who disagree with you are all money grubbing.
They really would though. Your ideology isn't the only ideology in the world, and there are people of sincere conviction who disagree with you.Posted by Ayn R. Key on 2010-10-16 16:40:50

Ayn,
A woman's right to an abortion, or any other reproductive service isn't something just made up since your described "Obamacare" was enacted. This is the law as afforded to women by our Constitution in the USA. In Italy, or the Vatican, they can do as they please and discriminate/kill any and all women there, but not here.
I would also submit that abortions have and will go on in Catholic Hospitals, right underneath the Church's nose, just like sex abuse. Why? The Church would rather keep feeding it's treasury than disrupt the power that it obtains by having said revenue stream.
Catholic Hospitals are a cash cow for the Church, as they are for secular investors, and hence, the sheer quantity of them you suggest that exist in this country. If the Church is anything, ANYTHING, it's a revenue hog, of any and all things medical, including abortion dollars!
And yes, I live in a Catholic Hospital, Catholic University neighborhood, with neighbors who both practice and "feed" the systems in place. They do, and would perform an abortion if the Church got paid handsomely to do it. If the woman is poor, and the State won't pay the "required" amount, the Church will not do the abortion. The Church is all about the money. Period.
It's silly to suggest that the Church is devoted and strict in it's doctrine on ANY subject that can potentially make the Church more liquid and profitable. Silly!Posted by LD on 2010-10-16 08:20:34

LD, let me break it down for you.
The Catholic Church would rather shut down a hospital than perform an abortion. The hospital will shut down that instant. The church may seek to sell, but the hospital will be closed while selling. The eventual buyer isn't buying a functioning hospital, but is buying a hospital building and has to build up a functional hospital from that.
Maybe if ruling comes down requiring abortions, every single Catholic hospital in the country will go on sale at the same time. Said hospitals will stay open performing every service except abortions, and will close if a sale is not completed and someone demands an abortion.
Yes, the moment the Church is faced with the choice - break secular law or break church law - that hospital will close so as to break neither law. Sure they may be willing to sell the hospitals, but unless the deal is complete that doesn't do your alternate scenario very much good.
Plus as the Catholic church runs the bulk of the charity hospitals, sale or closure - either way - will destroy what remains of charity hospitals in this country.
A fierce dedication to abortion can have unintended consequences.Posted by Ayn R. Key on 2010-10-15 23:07:33

LD, how many people do you know who are involved in any way with the management of a Catholic hospital?Posted by Ayn R. Key on 2010-10-15 22:28:58

The suggestion above by Ayn Key that "...15 percent of the beds to disappear," if secular law, Roe v Wade, is enforced upon Catholic hospitals as the law of the land in this country, is not only preposterous, but assumes that the hospital beds would just simply "disappear" from our current supply should the Catholic Church close shop on them.
Believe me, there is plenty of upper echelon cash available, waiting to be invested in good return-on-investment organizations, and a simple directive by the government to encourage investment into hospitals through tax breaks and incentives would be simply be a matter of flipping switch in Congress should there be a need. Mergers and Acquisitions are at a feverish rate in this country in this economic climate, and this would be a valuable investment opportunity.
And Rick Stump's suggestion that a 50% PPH pregnancy mortality rate is not enough of a risk to the mother's life should she continue with the pregnancy, is similarly preposterous, and most notably misogynistic.
Let's look at it from a flip a coin perspective. Throw a coin in the air, catch it, and place it on the top of your other hand. Heads, you live. Tails, you die. That's a 50% mortality rate due to this condition. Just because the people at risk of dying are women is no excuse that a 50% mortality rate isn't enough of a death risk!Posted by LD on 2010-10-15 17:45:23

I was disappointed pretty quickly with this piece by this writer's obvious lack of understanding of what it means to choose a life of service to God. The choice to serve God is not a job nor is it a career.
This courageous woman of God who believed so strongly about abortion that she hazarded the Roman Church's wrath to follow her conviction.
I do not have to agree with her position to admire her willingness to put her ministry on the line to follow that conviction.Posted by Rev. Michael Weaver-Robbins on 2010-10-15 17:03:58

"Due to her condition, the woman would almost certainly have died without the abortion"
This is false. While initial studies of untreated PPH in pregnancy indicated that mortality rates can go as high as 50%, that is still not 'almost certainly would have died'. Factor in that the cases of mortality in women receiving treatment have dropped steadily from about 22% in the '70's to about 5% today and, well, this statement and the follow on "...he difficulty of the choice McBride faced—whether to protect the fetus until the mother’s near-certain death ... " is inflammatory and false.
So - Sr. McBride made a lousy callPosted by Rick Stump on 2010-10-15 10:25:23

Be very careful. As the article noted, the Catholic Church has 15 percent of the nation's hospital beds, and roughly all the non-government charity hospitals. Having a family member work for a Catholic hospital, it is well known that if any hospital is forced by secular law to provide any reproductive service that is banned by church law, that hospital will close rather than provide that service.
It's a dangerous line the progressives are taking on this one. With insurance companies raising rates and dropping services in response to Obamacare, the last thing needed is for 15 percent of the beds to disappear.
This may force progressives to choose - is it more important to force people to provide abortions, or more important to provide medical care at all?Posted by Ayn R. Key on 2010-10-14 10:21:22